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Hepatitis Flashcards

(48 cards)

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1
Q

Define anicteric hepatitis

A

symptoms but no jaundice

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2
Q

Define icteric hepatitis

A

symptoms with jaundice

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3
Q

Define fulminant hepatitis

A

severe jaundice with hepatic failure and high mortality

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4
Q

what enzymes’ levels will be raised in acute hepatitis and why?

A

alanine aminotransferase and
aspartate aminotransferase because
excess quantities are released by damaged hepatocytes

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5
Q

Who is likely to be Infected with hept A?

A

children <5yrs - anicteric or subclinical,

adults too, gets worse with age

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6
Q

presentation of hept A?

A 
fever,
malaise, 
anorexia, 
n/v,
upper abdominal pain, 
jaundice and dark urine 3-10 days post incubation
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7
Q

How is hept A spread?

A

faecal-oral route,
faecal-contaminated food/water,
sex,
injecting drugs

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8
Q

what antibodies are present in serum in the first 3 months of infection with hept a?

A

HAV IgM antibodies

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9
Q

Prophylaxis treatment of hept a?

A

Human normal immunoglobulin (gives protection for 4 months)

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10
Q

Who should receive hept a immunisation?

A 
sewage workers, 
seronegative haemophiliacs, 
MSM with multiple sexual partners, 
travellers to endemic areas,
people who inject drugs (PWID),
chronic liver disease
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11
Q

prognosis of hept a?

A

recovery is slow but very rare to die from fulminant hept a

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12
Q

Presentation of acute hepatitis B?

A 
anorexia, 
lethargy,
nausea, 
fever, 
abdominal discomfort, 
arthralgia, 
urticarial skin lesions, 
jaundice, 
dark urine
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13
Q

After infection with hepatitis B, how long until symptoms appear?

A

few weeks- 6 months

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14
Q

What are the 3 viral forms of hept b seen in blood?

A

infectious viral particles,
non-infectious spheres,
tubules which consist of hept b surface antigen

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15
Q

What are the major markers for identifying hepatitis B?

A

serum HBeAg and HBV-DNA show viral replication and HBsAg (acute and chronic hept B),
HBeAg (chronic hept B)

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16
Q

Routes of transmission of hepatitis B?

A

vertical,

horizontal (eg sex, needle)

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17
Q

what antibodies indicate recent hept B infection

A

anti-HBc IgM antibodies

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18
Q

Define chronic HBV infection?

A

presence of HBsAg in serum for more than 6 months

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19
Q

what long term sequelae are hept B patients at risk of?

A

chronic liver disease,
membranous glomerulonephritis,
polyarteritis nodosa

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20
Q

indications for anti-viral therapy in patients with hept B and no cirrhosis?

Study These Flashcards
A

2/3:
HBV DNA >22000 IU/ml,
raised ALT,
significant liver inflammation or fibrosis

21
Q

Treatment for hepatitis B?

Study These Flashcards
A

pegylated a-interferon,
entecavir,
tenofovir,
liver transplant

22
Q

what are the 3 most important ways to prevent HBV infection?

Study These Flashcards
A

immunisation,
infection control procedures,
screening of blood donors and transplant donors

23
Q

people who should receive hept b vaccine?

Study These Flashcards
A 
healthcare personnel, 
travelling to endemic areas, 
renal dialysis, 
change sexual partners quickly, 
PWID,
close contact of patient with hept b, 
select emergency services
24
Q

most common prognosis of hepatitis C?

Study These Flashcards
A

chronic HCV infection

25
presentation of HCV
``` ususally subclinical, in 20%: malaise, anorexia, fatigue, severe hepatitis, jaundice ```
26
Transmission methods of HCV?
blood, needles (IDU, tattoos, body piercing), sexual transmission, mother-to-child
27
Investigations for HCV?
Serum ALT, | detection of HCV antigen and HCV-RNA
28
Treatment for HCV?
alcohol abstention, immunisation for hept A and B, combination of pegylated a-interferon and ribavirin
29
What are the 4 response patterns to antiviral treatment?
non-responder, viral breakthrough, relapser, sustained viral response
30
Hepatitis d is always found with which hepatitis?
B, | thus D is termed a "defective" virus
31
What are the 2 ways hepatitis D presents?
co-infection (simultaneous infection of hept B and D) | Superinfection (infected with D after B)
32
Transmission of hepatitis D?
IDU (most common), blood, sex
33
Investigations for hepatitis D?
detect IgG and IgM antibody to HDV, HDV-RNA and HDAg in serum
34
treatment of hepatitis D?
pegylated a-interferon, | liver transplant
35
HEV mean incubation period?
40 days
36
transmission of HEV?
sporadic, faecal-oral route exposure to under cooked pig products
37
what's the difference between the 4 geontypes of HEV?
1 and 2 cause endemics in developing countries, 3 and 4 worldwide, 3 responsible for sporadic cases
38
Investigations for hepatitis E?
serological tests for IgG, IgM and HEV-RNA
39
What can cause hepatitis in the neonate?
prenatal- rubella, cytomegaolvirus | perinatal- cytomegalovirus, HSV, parechovirus and enterovirus)
40
Non-viral infections that can cause hepatitis?
leptospirosis, Qfever, psittacosis/ornithosis
41
What should you do after percuatneous exposure to blood/ bodily fluids?
encourage bleeding, wash with soap and water, waterproof plaste, report injury
42
when are health care workers excluded from performing EPP (exposure prone procedures)
Hept B e antigen +ve, hept B surface antigen +ve and HBV DNA of >1000copies/mL blood, hept C PCR +ve
43
which hepatitis virus are spread via faecal-oral route?
Hepatitis A and E
44
How can hepatitis A be prevented
``` good personel hygiene, good sanitation, clean water, Human normal immunoglobulin, active immunisation ```
45
which hepatitis viruses are spread by infected blood?
Hepatitis B, C, D
46
How can hepatitis B, C and D be prevented?
Infection control precautions, screening blood products, hept B vaccination
47
what is the clinical significance of prolonged HBsAg and HBeAg carriage
risk of long term sequelae eg chronic liver disease, cirrhosis and hepatoma
48
what factor is essential for transmission of hepatitis D?
Presence of HBsAg

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